Office Hours Recap: What if parents say their child's suicidal thinking is "attention-seeking"?

It's not just parents who can hold these beliefs, but friends or loved ones of adults may also think of suicidality as “attention seeking.” Here are some strategies we brainstormed together at Office Hours.

• Start with empathy and understanding. Assume positive intent and remember – this person may be scared and unsure of what to do, or they may feel ill-equipped to help their loved one.
• Offer a reframe. Here are two ways you could do this:
  • You can use a variation of the mini-intervention Ground your optimism in experience and evidence. You might say: 
    “It’s not uncommon for parents (or loved ones) to believe suicidal thinking is attention-seeking. We know that if we can work to understand what’s behind that thinking, and address those things, we can really help the person feel better. It can be helpful to think more about why they are saying it and how we can help engage with those underlying reasons.”  
  • Introduce the idea that seeking attention can also be a way of asking for help or seeking connection. Sometimes, it can be useful to reframe “attention” seeking to be “attachment” seeking. Young people may not have the words to express their pain, and attention-seeking behaviour can be a way of meeting an unmet need.
• Sit next to rather than across. Sitting next to the parents signifies a more collaborative and less confrontational stance, which can foster trust and open communication. This approach creates a sense of "being in this together" rather than the adversarial or confrontational dynamic that sitting across from them might imply.
• Show them the framework. Show the parents or loved ones that you have a consistent approach for helping people who are experiencing suicidality – the SafeSide Framework. As you walk them through the framework, highlight that there are places in each core task where the parent or loved one can have a role in helping and note that they are not alone in this process.
  • In this way, you externalise the focus. By working together through a framework which is "outside of us," you create an environment in which parents feel supported. The shift to an external focus can also help avoid potential power struggles.
• Collaborate around the common goal of helping the person feel better. Framing a goal for the person at risk that the parents and team can collaborate around – the goal of feeling better, the goal of getting back to school or work, the goal of doing what they love – can help shift the focus from “why” the person is feeling suicidal to “what” we can do to work toward helping them feel better.  
• Involve the loved one or parent in the assessment. Here are a few areas to focus on:
  • Focus on strengths and protective factors. When gathering information to inform an assessment and plans, start with strengths and protective factors, and gradually progress from there. During this discussion, we can assess if there are any new stressors or changes in behaviour that need attention.
  • Invite input on symptoms, suffering, and recent changes. You might ask them to share their perspective on how the person has been recently, what has changed, and what they were noticing that let them know the person was struggling.
  • Ask for input on understanding risk now compared to their history. Families and loved ones will often have a good sense of how the child or person’s current situation compares to the past, which can inform your thinking about risk state (risk compared to their own history). If you learn that this is one of the worst times, you will want the plans and responses in place to be robust and should ensure the parent or loved one has a clear role in those plans whenever possible. You might ask:
    • “How does what they’re going through right now compare to other times in their past?”
    • “Is this one of the worst times they have experienced?”
  • Talk together about foreseeable changes. Educate the parent or loved one about foreseeable changes and why we ask about them. Invite them to suggest foreseeable changes for which they could develop a contingency plan.

Additional resources:

A SafeSide member mentioned that they have found Circle of Security helpful. Circle of Security provides training and resources to help providers introduce caregivers to attachment principles and assist them in connecting with the children in their lives. 

Note: This is one of the recaps from our monthly Office Hours sessions where SafeSide members can ask questions and share their experiences. Members also have access to Community of Practice with the full library of recaps, newsletters and resources.